You will need to sign on with your LLLID (La Leche League ID) before you can post. If you have never claimed your LLLID, create your LLLID now. To sign in, click the LLLID Sign On button in the upper right corner. Enter your LLLID Alias and click the button again.

8 days old: how do I know she's done nursing?

My 8 day old, late-pre-term baby needs encouragement to stay at the breast. I try to keep her going for 20 minutes on each side at daytime feelings*, though I could probably keep her going longer with increased prodding. How do I know when we've reached the point of diminishing returns & I should just let her sleep? I'm particularly interested in getting enough hind-milk in her to help her gain some weight!

*At night she cluster feeds with short sessions of 10 or 15 minutes and then, maybe, half an hour of resting. If feeds are that close together is she getting fore milk or hind milk?

Re: 8 days old: how do I know she's done nursing?

"This is not simply a case of the longer the feed, the higher the fat content: if there is a shorter gap between feeds (such as during periods of cluster feeding), the milk at the beginning of a feed may not necessarily be low in fat (2,10)."

But I'm still wondering about the first piece. Also, I often bread her latch because she's basically fallen asleep & I'm trying to save my poor nipples. So I'm not allowing her to fall off herself as recommended elsewhere. Is that okay? Or it it worth it to wait for her to come off on her own?

Re: 8 days old: how do I know she's done nursing?

Generally you can know baby is done nursing when she comes off the breast, and no longer will go back on if offered, or baby falls asleep and is no longer suckling. Some babies suckle in sleep and that is fine, if its been awhile and you need to unlatch baby that is fine too.
Nursing frequency is the most important thing. You can expect a newborn to nurse 10-15 times a day or so.

I strongly urge you to forget everything you have ever heard about foremilk and hindmilk. Simply put the idea that milk may go through these very subtle and gradual changes during a feeding out of your mind. IMO this is almost always useless information and only causes more confusion and needless concerns. If your baby starts gaining more than one ounce a day, cries and pulls off when nursing due to an enormous flow, is desperately uncomfortable (not just fussy) intestinally, usually pooping explosive frothy green poops, and you regularly become engorged despite baby nursing frequently, then you may have a foremilk hindmilk issue.

trying to save my poor nipples.

what are you doing for the sore nipples? This is very important. Your nipples should not be sore no matter how long baby nurses. This is a sign of a not great latch. Have you seen an IBCLC? Have you tried differetn position, latch techniques?

I have to go and may not be back to the computer tonight. Here is my list of latch help I like. Tips with pictures on latch and different positioning ideas (includes side lying) http://www.llli.org/faq/positioning.html

Here are two simple pictorials, you want the one on latch. Notice that the mother is in a “slightly” laid back position, looks like on a couch? This is a very “adjustable” position, play around to find how you and your baby are most comfortable. http://cwgenna.com/quickhelp.html

Re: 8 days old: how do I know she's done nursing?

Thanks for your reply! I've been to see a LC and she gave me some tips on latch but said mine looks good. In the evenings while cluster feeding Baby gets frustrated and starts turning her head around taking my nipple with it - not too comfortable no matter the latch!
She's been gaining really well and we're weaning off pumped supplements. Yay! The weight gain makes me a lot more confident in taking her off the breast when she seems done. I don't think she's ever actually dropped my nipple. She'd probably stay latched all day if I let her!

New question: she's been having greenish poops and a rumbly stomach. The pediatrician thought the green poops could be a fore milk issue especially given all the pumping we've been doing (I know, I know, I'm supposed to ignore all that, but the pediatrician brought it up!). Will this just resolve itself as we reduce the amount of pumping?

Re: 8 days old: how do I know she's done nursing?

Even if it is an issue of too much foremilk, is there any reason to worry about it? Green poops and a rumbly tummy are not a health issue.
I am unclear why or how often you are pumping so i cannot say if not pumping will stop the green poops. But when a mom has overproduction, as is somewhat common in the early weeks, once it calms down, as it does normally over time, yes, any issues caused by forceful letdown also calm down. But typically a mom with overproduction would not be needing to pump. Hope that helps!

Re: 8 days old: how do I know she's done nursing?

Nursing is sometimes still uncomfortable - usually not until after she's done. The LC thinks it's vasospasms & just putting my warm palms over my nipples seems to help. Getting out of the shower is the worst. It stinks, but I'm hoping it'll go away.
I was pumping like crazy because I was having problems with low milk supply & baby wasn't transferring enough (weigh-feed-weigh) or gaining. We may have overshot a little in correcting the problem. I'm a little engorged tonight after a week & a half of LC Boot Camp. But if it is oversupply due to megapumping & fenugreek, that seems like a much easier problem to solve than under supply.

I'll add, lately, I can sometimes hear a lot of gulping when she first latches on (especially if I'm compressing my breast which I sometimes still need to do). Maybe that's a forceful let-down? Or maybe just finally normal nursing?

Edited to add: if you have any recommendations for how to get her to stop throwing her head back while nursing I'd love to hear them. I'm nursing in football hold & cross body hold. I try to keep her cuddled in on her side. She mostly does it when my milk starts coming slower at the end of nursing. She arches her back and pulls her head back and boy does it hurt. I try keeping her head cupped in my hand to reduce her movement backwards, but even half an inch is rough!

Re: 8 days old: how do I know she's done nursing?

Edited to add: if you have any recommendations for how to get her to stop throwing her head back while nursing I'd love to hear them. I'm nursing in football hold & cross body hold. I try to keep her cuddled in on her side. She mostly does it when my milk starts coming slower at the end of nursing. She arches her back and pulls her head back and boy does it hurt. I try keeping her head cupped in my hand to reduce her movement backwards, but even half an inch is rough!

nurse reclined w/baby more on top of you. Baby can be in any position. Also try to not touch or press on back of baby's head as this will cause that head toss. Also try sidelying position- see links for more on both

Here are two simple pictorials, you want the one on latch. Notice that the mother is in a “slightly” laid back position, looks like on a couch? This is a very “adjustable” position, play around to find how you and your baby are most comfortable. http://cwgenna.com/quickhelp.html

Nursing is sometimes still uncomfortable - usually not until after she's done. The LC thinks it's vasospasms & just putting my warm palms over my nipples seems to help. Getting out of the shower is the worst. It stinks, but I'm hoping it'll go away.

have you researched vasospasms & Raynards syndrome?

I'm a little engorged tonight after a week & a half of LC Boot Camp. But if it is oversupply due to megapumping & fenugreek, that seems like a much easier problem to solve than under supply.

no need to pumop anymore if you have enough milk. You may need to wean off pumping to lessen engorgement (or just encourage baby to nurse more often,)

Re: 8 days old: how do I know she's done nursing?

The only reason to worry about the green poop/oversupply is that she's had trouble gaining weight. But now that we've seemed to (hopefully...fingers crossed) fixed the low supply issue I can maybe stop worrying about weight gain. I'm hopeful. We're doing another weigh in on Monday.

I've only researched Raynards online. Basically I googled it and read what I found. Short of that blood pressure medication, I'm trying what's recommended. It seems to help a smidge.

Thanks for the recommendation about not holding the back of her head, I remember the LC at the hospital saying that but I'd forgotten. I'm hopeful that'll help!

Re: 8 days old: how do I know she's done nursing?

Those videos are great!
I guess my question was about what to do when she's no longer actively sucking & swallowing. For example, for the past 3 hours she's been on and off (mostly on) the breast. When I first switch her she actively swallows for maybe 4 minutes and then switches to just sucking and then nibbling. So, I switch her and the cycle repeats on&on&on&on&on. If I take her off she's ok for maybe 10 minutes but then starts rooting and sucking her fist and crying, so I put her back on to nurse. She seems hungry. All.the.time. She seems completely satiated only maybe a few times a day. The IBCLC said we'd know she was done when she seemed drunk, but that so rarely happens!
So my question is: when is she done & I can stop and rest and just try to distract her? Or, When is she done and I should give her expressed milk (which satiates her for a bit longer than nursing but not long)? Or, When is it important to just keep nursing?
Because she was slow to gain weight & my milk has been slow to come in, I'm nervous about ever distracting her when I could be feeding her-- but I'm also nervous about keeping her at the breast when it's clearly not satiating her. Not to mention the fact that I really really need a nap.

(Just yesterday I was feeling so much more confident, but today I'm back to not knowing what to do)